17e. MSK - Ankylosing Spondylitis Flashcards
What is ankylosing spondylitis (AS)?
Types of chronic inflammatory arthritis affecting spine and sacroiliac joints
At what age does AS commonly start?
20-30 years
Which gender is more likely to be affected by AS?
Males
Signs and symptoms of AS
Chronic back pain (improves with movement)
Back stiffness
Achilles tendonitis
Plantar fasciitis
Uveitis
Fever
Fatigue
Causes and risk factors for AS
Genetics
Biomechanical stress
Microbial cross-reactivity
GI inflammation
Gut dysbiosis
Impaired intestinal barrier
Which genes/SNPs are implicated in AS?
HLA-B27
IL-23R
ERAP1/2
A dysfunction between which IL and immune response has been identified as a key driver of chronic inflammation in AS?
IL-23
Th17
Which immune response is thought to be a driving factor in AS?
Molecular mimicry
(between microbial antigens and HLA-B27)
Why is biomechanical stress a risk factor for AS?
Associated with microdamage from repetitive strain
Promotes chronic inflammation in susceptible individuals
Cross-reactivity with which bacteria is a risk factor for AS?
Klebsiella pneumoniae
(with HLA-B27)
Which gut bacteria is mostly seen reduced in AS?
Faecalibacterium prausnitzii
Which gut bacteria is mostly seen increased in AS?
E. coli
Natural approach to supporting AS
Naturopathic diet
Low starch diet
Fasting
Restore gut health
Manual therapy
Exercise
Breathing exercises
Why can a low starch diet be good for AS?
Lower ESR levels
Reduced growth of Klebsiella
Reduced LPS absorption
Why can fasting be good for AS?
Reduce pain/stiffness
Positive immunomodulation
(reduced monocytes/inflammatory cytokines)
